后路全椎板切除减压并椎弓根内固定治疗胸椎后纵韧带骨化合并黄韧带骨化

目的探讨对胸椎后纵韧带骨化(ossification of posterior longitudinal ligament,OPLL)合并黄韧带骨化(ossification of ligamentum flavum,OLF)患者行后路全椎板切除减压并椎弓根内固定治疗的临床疗效。方法回顾性研究2008年7月~2013年4月,15例胸椎OPLL并OLF患者行后路全椎板切除减压并椎弓根内固定术治疗。分别统计患者一般情况、手术时间、出血量、卧床时间、术后并发症发生率、术前术后日本骨科学会(Japanese Orthopaedic Association,JOA)评分,并进行比较。结果平均随访38.7个月,患者术前、术后3个月及末次随访时JOA评分分别为3.9±1.2、8.1±2.2及10.3±2.5,差异具有统计学意义(P<0.05)。术中1例患者出现脑脊液漏,术后1例患者出现浅表伤口感染,1例患者出现血肿。结论胸椎OPLL并OLF患者行全椎板切除减压并椎弓根内固定术治疗,可获得满意的临床疗效。但该术式容易造成严重脊髓损伤,对术者技巧要求较高。

Decompression with posterior laminectomy and pedicle screw fixation on thoracic ossification of posterior longitudinal ligament and ligamentum flavum

Objective To study the clinical efficacy of decompression with posterior laminectomy and pedicle screw fixation on thoracic ossification of posterior longitudinal ligament(OPLL)and ligamentum flavum(OLF).Methods From July 2008 to April 2013,15 patients who suffered from thoracic OPLL and OLF were decompressed with posterior laminectomy and pedicle screw fixation. Demographic data,operative time, blood loss, complication rate,improvement rate (IR) and the pre- and postoperative Japanese Orthopedic Association (JOA) scores were recorded and compared statistically.Results After 38.7 months of follow-up,statistical significance was found with respect to pre- and postoperative JOA scores(P<0.05). Intraoperative leakage of cerebro-spinal fluid (CSF) occurred in 1 case, postoperative wound infection and hematoma happened in 1 case, respectively. Conclusion The clinical efficacy of decompressed with posterior laminectomy and pedicle screw fixation on thoracic OPLL and OLF was satisfying. The process needs exquisite technique and could cause spinal cord injury easily.